February 25, 2015
The U.S. House of Representatives Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a budget hearing for the Department of Health and Human Resources. HHS Secretary Sylvia Burwell was the sole witness and answered questions about the President's FY2016 budget priorities.
February 2, 2015
The President released his budget for the 2016 fiscal year, which begans October 1, 2015. This memo offers specifics regarding academic family medicine budget priorities. The release of the President's Budget signals the beginning of appropriation conversations with Congress. These conversations will continue until Congress passes a spending bill and the President signs the bill into law.
January 13, 2015
The Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD) released its 11th report. The report, titled “Training Health Professionals in Community Settings During a Time of Transformation: Building and Learning Integrated Systems of Care,” focused on the necessity of interprofessional training and the report provides recommendations for achieving an integrated healthcare system. Read the full report.
January 6, 2015
The new 114th Congress begins today with a Republican controlled House and Senate. Representatives and Senators will be sworn in and begin a 2-year legislative session.
December 16, 2014
The Consolidated and Further Continuing Appropriations Act which provides discretionary funding for most of the federal government through September 30, 2015 was signed by President Obama today.
December 13, 2014
The U.S. Senate voted 56-40 on a $1.1 trillion spending bill that will fund the government until September 2015. The bill will now be sent to President Obama and he is expected to sign the bill into law.
December 12, 2014
Late last night, the U.S. House of Representatives passed a $1.1 trillion dollar spending bill that will fund the government until September 2015. Now the bill will be sent to the Senate where it is expected to pass.
December 9, 2014
The U.S. House of Representatives released a spending bill for FY2015. Read the summary that details the funding levels for specific academic family medicine programs. The bill is expected to pass the House and will be sent to the Senate for a vote.
December 5, 2014
Secretary of Health and Human Services Sylvia M. Burwell responded to a September 17 letter from the Advisory Committee on Training in Primary Care Medicine and Density. The letter called for reauthorization and increased funding for the THCGME Program. Burwell expressed her understanding of the value of the program and stated she is happy to work with Congress in the future. Read the letter.
December 1, 2014
The Council of Graduate Medical Education released their 22nd report: The Role of Graduate Medical Education in the New Health Care Paradigm on November 26. The report focused on training physicians to achieve new competencies and aligning future Graduate Medical Education (GME) and GME funding to new health care delivery methods. There were seven recommendations for educators and policymakers of GME in the report. One recommendation that should be highlighted "Recommendation 4: GME funding for the Teaching Health Centers and Children's Hospitals should be stabilized with dedicated ongoing funding." Read the full report.
November 11, 2014
The Department of Veterans Affairs (VA) Secretary Robert McDonald announced in an interview with CBS "60 Minutes" on November 9th that he plans to hire 28,000 medical professionals to join the agency's hospitals and clinics. That number also includes about 2,500 mental health professionals. One planned incentive to persuade young doctors to join the VA health system is student loan forgiveness.
September 26, 2014
The Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD) sent a letter to Secretary of Health and Human Services Burwell, the Senate Committee on Health, Education, Labor, and Pensions, and the Senate Committee on Energy and Commerce on September 17, 2014. The letter urges for "reauthorization and a doubling of funding for the Teaching Health Center Graduate Medical Education (THCGME) program for no less than 5 years." Without reauthorization the THCGME program will expire at the end of FY 2015. Read the letter (pdf).
September 19. 2014
H.J. Res. 124 passed in the U.S. Senate and was quickly signed into law by President Obama. The bill will fund the federal government, at current spending levels, until December 11, 2014. Congress will have to return after the November elections to work on the remainder of the FY2015 spending bill.
September 18, 2014
Last night, the US House of Representatives voted 319-108 to pass spending bill H.J. Res. 124. The bill will now go to the US Senate for a vote and H.J. Res. 124 is expected to pass before the end of the week. If signed into law the bill will continue funding the federal government, at current levels, until December 11, 2014. This means Congress will have to come back after the November elections and deal with the rest of the FY2015 spending bill.
September 10, 2014
The US House Appropriations committee introduced a short-term spending bill (H.J. Res. 124), known as a continuing resolution, to fund the government beyond September 30, the start of the new fiscal year. If passed, the bill will continue funding the federal government, at $1.012 trillion, which is current levels until December 11, 2014. Some additional funding is included under the Labor, Health and Human Services, Education and Related Agencies jurisdiction for Ebola-related research and response efforts. To keep under the funding cap, other accounts would bear reductions to accommodate the new funding under the funding cap.
September 8, 2014
The Senate and House of Representatives are back in session today after a month-long recess.
September 3, 2014
The Institute of Medicine (IOM) announced a public webinar for Monday, September 22, 2014 at 12:30 pm EST. The webinar will focus on a review of the IOM committee's recent report, Graduate Medical Education That Meets the Nation’s Health Needs, and also allow the public to participate in a discussion of the report's findings.
August 26, 2014
HHS Secretary Burwell announced $35.7 million in Affordable Care Act funding to health centers that support patient-centered medical homes. The funds will be received by 147 health centers in 44 states, D.C. and Puerto Rico. Awarded health centers will use the funds to support 21 new construction projects and 126 renovation projects. These projects are expected to improve patient-centered medical home facilities that will allow health care workers to provide better quality care to the communities that rely on their services.
August 7, 2014
President Barack Obama signed H.R. 3230, the Veterans Access, Choice, and Accountability Act of 2014, into law. This law calls for an increase of up to 1,500 graduate medical education residency positions at VA medical facilities over the course of 5 years. VA facilities that do not have a medical residency program and those that are located in a community that has a large number of veterans will be given priority for these additional residency positions.
August 1, 2014
Last night the Senate voted 91-3 to pass H.R. 3230, the Veterans Access, Choice, and Accountability Act of 2014. The bill will now be sent to President Obama who is expected to sign it into law.
August 1, 2014
Yesterday, Senator Patty Murray (D-WA) introduced S.2728, the Community-Based Medical Education Act. The bill would extend the Teaching Health Center program until 2019 and also create 1500 new primary care residency slots throughout the country. CAFM has been very involved in the development of this bill.
“We congratulate Senator Murray on her work to develop this much needed legislation that offers greater accountability of taxpayer dollars," said Grant Hoekzema, MD, chair of CAFM. "Significant reforms to Medicare graduate medical education to increase primary care production and community-based training are included in the bill. In particular, we are especially appreciative of the inclusion of dedicated, stable funding for new types of teaching entities.”
July 30, 2014
The House of Representatives voted 420-5 to pass H.R. 3230, the Veterans Access, Choice, and Accountability Act of 2014. H.R. 3230 will now be sent to the Senate and the bill will likely pass before the August recess.
July 29, 2014
Senator Bernard Sanders (I-VT) and Representative Jeff Miller (R-FL) signed a conference committee agreement on H.R. 3230, the Veterans Access, Choice, and Accountability Act of 2014. The bill language calls for an increase of up to 1,500 graduate medical education residency positions at VA medical facilities over the course of 5 years. VA facilities that do not have a medical residency program and those that are located in a community that has a large number of veterans will be given priority for these additional residency positions.
Robert McDonald was confirmed as Veterans Affairs Secretary with a U.S. Senate vote of 97-0.
July 28, 2014
Senate Veterans' Affairs Chairman Bernard Sanders (I-VT) and House Veterans' Affairs Chairman Jeff Miller (R-FL) held a press conference today to announce a $17 billion Veterans Affairs (VA) health care bill. The bill includes $10 billion for private care options for veterans, such as access to private medical providers and community health centers. The bill also includes $5 billion that will go directly to the VA to hire additional doctors and other health care workers and to address some of the space problems at facilities. We have heard that the bill language also contains an increase in funding for additional graduate medical education residency slots, but we won't be able to confirm that until the bill language becomes available.
July 22, 2014
The DC Appeals court ruled Americans cannot get subsidies to help pay for their health insurance if they purchase insurance policies through HealthCare.gov. According to the ruling in Halbig v. Burwell, only those who purchase insurance through the state-run exchanges are eligible for the subsidies. A similar case, King v. Burwell, in the U.S. Court of Appeals for the 4th Circuit in Richmond, VA ruled in favor of the insurance subsidies. Due to some ambiguity in the language of the Affordable Care Act, these questions are making their way through federal courts and may not be answered fully until they make their way up to the Supreme Court. As of now no one will be affected by the rulings because the legal battle will continue.
July 15, 2014
HRSA announced that 22 Community Health Centers in Florida, Maryland, New York, and Massachusetts are eligible for $11 million in funding to integrate HIV services into their primary care practices. The funds come from the Affordable Care Act and the Secretary’s Minority AIDS Initiative and are part of a cooperative agreement between HRSA and the CDC. According to HRSA, "The project will enable HRSA-funded health centers to work with CDC-funded state health departments to expand the provision of HIV prevention, testing, care, and treatment services, especially among racial/ethnic minorities." View the press release.
July 8, 2014
Health and Human Services Secretary Burwell announced $100 million in Affordable Care Act funds to expand health center sites throughout the U.S. in 2015. The funds will add an estimated 150 new health center sites to the more than 550 new health center sites that have opened since the Affordable Care Act was passed into law in 2011. View the press release.
July 7, 2014
Health and Human Services Secretary Burwell announced $83.4 million in funding to support primary care residency programs in 60 Teaching Health Centers (THC) in the U.S. The funding is the 4th year of the 5 year authorization of the THC program. It will be used to train more than 550 residents during the 2014-2015 academic year, an increase of more than 200 from the previous year. CAFM continues to advocate for the reauthorization of the THC program which currently expires in FY 2016. View the press release.
June 30, 2014
Former Proctor & Gamble CEO, Robert McDonald, has been nominated to become the new Secretary of Veterans Affairs. McDonald is a West Point graduate and served in the U.S. Army for five years. McDonald has no medical background. If confirmed by the Senate, McDonald will replace Eric Shinseki, who resigned in May due to the Veteran's Affair scandal involving false waiting lists and times for veterans who were waiting to receive health care.
June 5, 2014
Sylvia Mathews Burwell was confirmed as Health and Human Services Secretary with a U.S. Senate vote of 78-17.
June 4, 2014
HRSA announced a new bureau, the Bureau of Health Workforce. CAFM staff participated in a Health Workforce stakeholder’s teleconference call with HRSA Administrator Dr Mary K. Wakefield and Associate Administrator Rebecca Spitzgo. The teleconference included details of the Bureau’s reorganization that puts over 40 programs under one bureau instead of spread out across HRSA.
The new Bureau of Health Workforce will include all programs previously under the auspices of the Bureaus of Health Professions and Clinician Recruitment and Services. Title VII health professions grants under the Division of Medicine and Dentistry will remain in that division. View the Bureau of Health Workforce organizational chart.
June 4, 2014
The U.S. Senate voted 67 to 28 to end debate and proceed with the nomination of Sylvia Mathews Burwell for Health and Human Services Secretary. She has now reached the final step in the process of being confirmed as the new Health and Human Services Secretary.
May 21, 2014
Senate Appropriators approved funding for the 2015 Fiscal Year (FY15) Labor/HHS/Education discretionary spending (appropriations.) It is in keeping with current (FY14) funding levels. The allocation of $156.773 billion for discretionary spending is $1 billion higher than the House allocation. The vote was along party lines 16-14.
May 21, 2014
The Senate Finance Committee voted 21-3 to send Sylvia Mathews Burwell's nomination for Health and Human Services Secretary to the full Senate. Burwell's confirmation is expected to be run smoothly and take place soon after the Senate returns from the Memorial Day break.
May 14, 2014
Sylvia Mathews Burwell, President Obama's nominee for HHS Secretary, completed her second of two Senate confirmation hearings. The Senate Finance committee is expected to vote to move Burwell's confirmation to the full Senate within the next month.
April 22, 2014
The US Department of Health and Human Services Health Resources and Services Administration (HRSA) released the Integration of Oral Health and Primary Care Practice report in February and recommended core oral health clinical competencies to be implemented within primary care practices to reduce oral health disparities in the United States. The HRSA says increased oral health knowledge in primary care workers will improve early detection and increase preventative interventions. Read the report to learn more about the recommendations.
April 9, 2014
CAFM attended the Senate HELP Subcommittee on Primary Health and Aging hearing “Addressing Primary Care Access and Workforce Challenges: Voices from the Field.” Family medicine advocates were well represented at the hearing. Family Medicine speakers included:
- Deborah Edberg, MD, Program Director, McGaw Northwestern Family Medicine Residency Program, Erie Family Health Center; Assistant Professor of Clinical Family and Community Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
- Allen Dobson Jr., MD , President and CEO, Community Care of North Carolina, Raleigh, NC
- Joseph Nichols, MD, MPH , Family Medicine Resident, MedStar Franklin Square Family Health Center, Baltimore, MD
March 14, 2013
The US House of Representatives passed the SGR repeal bill, HR 4015, by a vote of 237-182. Unfortunately,the bill amends part of the Affordable Care Act by including a delay in the individual mandate until 2019 and a removal of the penalties for not signing up for health insurance. The Senate still needs to pass a version of the repeal and would then need to negotiate the differences with the House bill, hopefully finding a different way to pay for the cost of the repeal without harming the Affordable Care Act. This would all need to happen by March 31, 2014 before the current patch on the SGR runs out.
March 12, 2014
Health and Human Services Secretary Kathleen Sebelius testified today on the department’s Fiscal Year 2015 Budget Proposal before the House Ways and Means Committee. A question asked by Rep. Thompson (D-CA) referenced his sponsorship of the family medicine supported bipartisan GME Primary Care Pilot bill, HR 487. Rep. Thompson asked for assurances that these grants would focus on support of training outside of hospitals and in community settings. Secretary Sebelius stated the new workforce initiative for competitive grants for residency training would emphasize HRSA’s workforce goals of targeting primary care and other shortage specialties, rural and underserved areas, and key competencies needed for health care delivery system reform.
The Friends of HRSA hosted a FY15 Budget Briefing with Health Resources and Services Administration (HRSA) Deputy Administrator Marcia Brand and other senior HRSA leadership. The panel provided a budget overview of key HRSA programs in the President’s budget including the new workforce initiatives. Attendees were able to ask specific questions about the proposals and raise support and/or concerns related to implementation.
March 5, 2014
The President’s Budget for Fiscal Year 2015 was released March 4. The budget signals the start of the budget and appropriations season and serves as a guideline of the Administration funding priorities. Several key areas of interest to academic Family Medicine are highlighted below. Each of these proposals requires legislative action to be implemented.
- Addressing physician workforce: Medicare Indirect Medical Education (IME) payments would be reduced by 10% with some of the savings redirected to create a new competitive grant program to fund training of 13,000 additional residents in primary care and other specialties in shortage. That program would incorporate two current workforce programs, the Teaching Health Center program and Children’s GME program, into a new budget line called the Targeted Support for Graduate Medical Education.
- National Health Service Corps (NHSC) would be funded at $810 million. Most of that would be a mandatory funding, but $100 million dollars in appropriations are requested this year. Over six years the Administration hopes to increase the field strength of the Corps from 8,600 providers to 15,000.
- Title VII Primary Care Training and Enhancement program would be funded at the current $37 million.
- AHRQ would be funded at the total program level of $440 million. This is a decrease of $24 million from FY2014.
February 7, 2014
Yesterday, Senator Max Baucus, (D-MT), long-time Chair of the Senate Finance Committee was approved by the Senate as the new US Ambassador to China. Senator Ron Wyden (D-OR) took his place as chair of the influential Finance Committee.
February 6, 2014
Three Congressional committees reached agreement on a plan to repeal the much-maligned Sustainable Growth Rate, which has had a negative impact on Medicare physician reimbursement for about a decade. The agreement, when enacted into law, would put in place a five year, 0.5 percent payment update, streamline multiple current quality programs into one value-based performance program to improve the fee-for-service system, incentivize the use of alternative payment models for physicians to enhance adoption of coordination and prevention services, increase Medicare transparency to patients, and provide data doctors can use to improve care.
The agreed-upon legislation (HR 4015 and S 2000) still needs to be funded, and that is a large hurdle to overcome. If Congress is unable to reach an agreement on how to pay for it, physicians face an approximately 24 percent cut on April 1, 2014.
January 28, 2014
President Obama delivered his annual State of the Union address to inform Congress and the American people about issues of the past and his plans for the future. One of the topics President Obama covered included the Affordable Care Act and a push for people to enroll in the available health plans.
January 15, 2014
On January 13, Congress released the Consolidated Appropriations Act of 2014. The bill provides funding for all the Appropriation spending bills and provides some sequester relief for programs that lost funding when the sequestration took effect. For example, the spending numbers released for the Labor, Health and Human Resources Appropriations committee include $245.4 million for Title VII, an 11.3 percent increase over FY 2013 post-sequestration funding levels. The bill must still be approved by both Houses of Congress and signed by the President, but this sets the stage for final passage of a 2014 spending bill.
January 3, 2014
On December 26, 2013 President Obama signed into law House Joint Resolution 59, which includes the Bipartisan Budget Act of 2013. Now that the legislation is law, when the House and Senate return from the Winter Recess, each chamber's Appropriation Committee will meet to discuss and set the federal spending levels for specific areas of the government the next two years. The Senate and House will be able to vote on the Appropriations bills and settle any differences between the two.
December 20, 2013
On December 18, the Senate passed House Joint Resolution 59 on a vote of 64-36. The joint resolution includes the Bipartisan Budget Act of 2013 and a three month patch on the SGR. H.J. Res. 59 allows the government to avoid another government shutdown and the House and Senate Appropriation Committees will be able to move forward to work out the details of funding the government for the next two years. The bill will now be sent to President Obama who has indicated that he will sign the legislation into law.
December 13, 2013
Last night, House Joint Resolution 59, which contains both the Bipartisan Budget Act of 2013 AND a three month patch on the SGR, passed the House on a vote of 332 - 94. The three month patch prevents the 20.1% cut in Medicare physician reimbursement due on January 1, 2014, and replaces it with a 0.5% increase until April 1, 2014. Although the House will go into recess today, the Senate will be in for another week. The Senate is expected to vote on the budget amendment (including the patch) the week of December 16th.
October 2, 2013
On October 1st Congress failed to pass a spending bill that would continue to keep the government running. With no bill in place the government has entered a shutdown and only essential government functions are still running. The President, Members of Congress and some of their staff will continue to work to reach an agreement on the spending bill. Until Congress and the President pass a spending bill, a majority of government workers and contractors will have to stop working. It is important to note that the government shutdown has not affected the implementation of the Affordable Care Act. Plans became available on October 1st and Americans have started signing up for health insurance.
April 18, 2013
The CAFM organizations signed on to a letter from the “Friends of AHRQ," a coalition of organizations that support the work of the Agency for Healthcare Research and Quality (AHRQ). The letter speaks to the important role AHRQ plays in improving Americans’ health, explains the value of the vital research being done by the agency, and requests an FY 2014 funding level of $434 million, consistent with the amount requested in the president’’s budget. The letter was signed by a total of 49 organizations.
April 10, 2013
President Obama released his budget on Wednesday, April 10. There were no major surprises in his requests for family medicine programs. This year, the president's budget requests $51 million for Title VII, Primary Care Training and Enhancement Programs, as it did last year. The budget would authorize the Agency for Healthcare Research and Quality (AHRQ) at a level of $434 million. Now that the president's budget is available, Congress can begin working to reconcile the levels he requested with those produced by the House and Senate Budget Committees. Read the Budget in Brief for the Department of Health and Human Services can be read here.
March 29, 2013
On Tuesday, March 26, President Obama signed the continuing resolution for Fiscal Year 2013, ensuring the government will continue running through September. Now Congress must work on addressing the budget for FY 2014. Congressman Paul Ryan (R-WI), Chairman of the House Budget Committee, released his budget plan, "The Path to Prosperity," which would balance the budget within ten years, primarily through major spending cuts. The House passed his budget plan on March 21. Senator Patty Murray, (D-WA), Chairwoman of the Senate Budget Committee, has also released a plan that aims to reduce the deficit by more than $4 trillion through a combination of stimulus spending, spending cuts, and increased revenue. The Senate passed her budget resolution on March 23. Yesterday, the White House announced that the president's budget will be released on April 10. The release of his budget will be the final piece of the budget puzzle and will allow the process of reconciling the different plans into one budget agreement to begin.
March 21, 2013
Today the House of Representatives approved an amended continuing resolution to fund federal programs through the end of Fiscal Year 2013 by a vote of 318-109. The Senate had amended and approved the bill the day before by a vote of 73-26.
With a few exceptions, the continuing resolution continues funding at FY 2012 levels, but the funding in the bill will be subject to the 5.1 percent cut mandated by sequestration.The bill also gives departments and agencies 30 days following enactment to submit an FY 2013 operating plan that reflects sequestration cuts. Senator Harkin's amendment, which would have provided funding levels negotiated in December for Department of Health and Human Services programs, rather than continuing resolution funding, failed to pass last week and was not attached.
The CR was sent to President Obama and awaits his signature.
March 12, 2013
The CR as released includes full appropriations bills for FY 2013 for the Departments of Agriculture; Commerce, Justice, and Science; Homeland Security; and Military Construction and Veterans Affairs. It also contains continuing resolutions for the remaining bills, including Labor, HHS, and Education. This would essentially continue funding at FY 2012 levels. Senator Harkin, Chairman of the Labor-HHS-Education Subcommittee has indicated he plans to file an amendment that would insert his subcommittee's spending bill, as negotiated in December, in place of a continuing resolution. We will keep you updated as more information becomes available.
March 6, 2013
The House of Representatives approved the "Department of Defense, Military Construction and Veterans Affairs, and Full-Year Continuing Appropriations Act" (HR 933) by a vote of 267-151. The bill allows the Departments of Defense, Military Construction, and Veterans Affairs some funding flexibility to absorb sequestration cuts. The bill also extends the current continuing resolution's FY 2012 funding levels for the remainder of the fiscal year, minus an across-the-board cut of 0.098 percent. This reduction is in addition to the 5.1 percent across-the-board sequestration cuts. The bill will now move to the Senate for consideration.
March 5, 2013
The House Appropriations Committee's Subcommittee on Labor-HHS-Education held an oversight hearing for HHS Public Health and Research Organizations. Witnesses were: Dr. Francis Collins, MD, PhD, Director of NIH; Dr. Tom Frieden, MD, MPH, Director of CDC; Dr. Carolyn Clancy, MD, Director of AHRQ; Dr. Patrick Conway, MD, Director of the Center for Clinical Standards and Quality, representing Medicare and Medicaid Innovation; and Dr. Mary Wakefield, PhD, RN, Administrator of HRSA. Each witness spoke to the importance of the work of their organization and its goals and answered questions from members of the subcommittee. The focus of the subcommittee's questions was whether or not the federally funded research done by these organizations is duplicative and whether or not cuts should be made. The witnesses focused on how their work is collaborative rather than duplicative, and each organization contributes a different piece to the research puzzle. Their written testimony is available on the Appropriations Committee's website.
March 1, 2013
The automatic spending cuts known as sequestration went into effect at midnight. Sequestration was mandated in the Budget Control Act to force Congress to reach a compromise on a budget agreement. The "American Taxpayer Relief Act" delayed the cuts until March 1st, but they will now be implemented to reduce the federal government's spending. Medicare, including GME payments and provider payments, will receive a 2 percent cut, and appropriated programs, like Title VII, will see a 5 percent cut to their budgets for the rest of FY 2013.
February 8, 2013
Health Affairs' February issue focuses on the "New Era of Patient Engagement." The publication covers a wide range of topics related to patient engagement, including a short piece on how the Patient-Centered Outcomes Research Institute (PCORI) is engaging patients in forming its research agenda.
February 7, 2013
February 7, 2013 is the opening day of the 2013 application cycle for the National Health Service Corps Loan Repayment Program. The cycle will be open for applications through April 16, 2013. More information about the program is available on the Department of Health & Human Services' website. The application is also available online.
January 2, 2013
Late last night, the House of Representatives held a vote on the Senate's "American Taxpayer Relief Act of 2012" to avert the fiscal cliff. The bill, which passed the Senate by a vote of 89-8, made it through the House with a vote of 257-167 and was signed by President Obama. The bill does not include any cuts to GME, and its passage delays the sequester's mandatory spending cuts for two months, temporarily preventing an 8% cut to discretionary programs like Title VII and a 2% cut to Medicare provider payments. The bill also freezes Medicare physician payment rates for one year, avoiding the 26.5% cut scheduled for the beginning of the year. However, this bill is only a temporary solution through March 1, 2013, and we will continue to advocate for family medicine education and research programs as legislators seek a more permanent resolution in the coming months.